The role of arterial hypertension in progression of renal failure.

The effect of arterial hypertension on the progression of chronic renal failure (CRF) was evaluated in 108 patients who eventually required dialysis in the 8 year period of the study. Patients' average serum creatinine (SCr) concentration at first examination was 239.7 +/- 45.3 mumol/liter and at the start of dialysis was 1,661.0 +/- 181.9 mumol/liter. The mean duration of pre-dialysis follow-up was 53.7 +/- 15.7 months. The mean monthly increase in SCr was 18.8 +/- 13.4 and 2.1 +/- 1.4 mumol/liter/month in hypertensive and normotensive CRF patients, respectively (P < 0.001). The CRF patients with a diastolic blood pressure (BP) < 89 mm Hg had a significantly (P < 0.05) slower rate of decline in renal function than the patients with a diastolic BP > or = 90 mm Hg. There was a significant relationship between a mean diastolic BP > or = 90 mm Hg and the rate of monthly increase in SCr (r = 0.81, P < 0.001). These data indicate that control of diastolic BP in CRF patients is a potentially effective way to slow the rate of decline in renal function.